No abstract available.

No abstract available.
Stents*

BACKGROUND: Despite general agreement as to the safety and immediate success of percutaneous iliac angioplasty, its long-term efficacy remains subjects to debate and percutaneous transluminal angioplasty(PTA) induced dissection in the iliac artery may also lead to urgent surgery although frequency of this complication is not clearly stated in the literature. The relatively early result with the use of the Palmaz balloon-expandable intraluminal stent(BEIS) for treating atherosclerotic iliac artery and PTA-induced iliac artery dissections strongly suggest that Palmaz BEIS has its important role for limitations of PTA.It is generally accepted that indications for stent placement are (a) inadequate immediate postangioplasty response (b) restenosis after previous iliac balloon angioplasty, and (c) total iliac artery occlusion. METHODS: We report the successful implantation of Palmaz BEIS at right common iliac artery in a patients suffered from severe claudication. Previously the patients received PTA two times. First PTA resulted in intimal dissection and restenosis occurred after successful second PTA. RESULTS: After successful implantation of Palmaz BEIS, pressure gradients across the lesion and blood flow pattern were nearly normalized. The patients was discharged without symptom and was in good condition after 4 months follow-up. CONCLUSION: According to our this limited experience and other reports, stent placement in valuable adjunct in the management of iliac artery disease.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Iliac Artery* ; Stents*

Left ventricular diverticulum is rare cardiac malformation;fewer than 30 cases have been reported in the world. We present a case of left ventricular diverticulum with chest pain suggested unstable angina. Myocardial rupture of this case was occured during cardiac catherization. patient was recovered and discharged. Relevant literature was also reviewed.
Angina, Unstable ; Chest Pain ; Diverticulum* ; Humans ; Rupture

PURPOSE: This study was designed to evaluate usefulness of intravenous digital subtraction angiography (IV-DSA) in detection of peripheral arterial obstructive disease(PAOD) and in follow-up of percutaneous transluminal angioplasty(PTA). MATERIALS AND METHODS: 35 Patients who had clinical symptoms and signs of compromised lower extremity perfusion, was screened with IV-DSA and then performed confirmative conventional angiography. We obtained sensitivity, specificity and accuracy of IV-DSA by comparing the findings of IV-DSA with those of conventional angiography. 21 patients who had been performed successful PTA, were foliowed-up with IV-DSA in 3, 6, 12months. We studied patency rate and factors that influenced restenosis. RESULTS: The sensitivity, specificity and accuracy of IV-DSA were 100%, 97%, 97% in lilac artery, 92%, 96%, 93% in femoropopliteal artery, 85%, 75%, 70% in proximal tibioperoneal artery retrospectively. IV-DSA follow up after PTA showed patency rate of 67% in first 3month, 67% in 2nd 3month, 60% in next 6month. Longer length and more irregular surface of the stenotic site, and higher incidence of run-off of vessel and of residual stenosis in the patients with restenosis were noted. CONCLUSION: High sensitivity, specificity and accuracy of IV-DSA in evaluating PAOD suggest that IV-DSA is useful in screening, planning therapy and following up after PTA.
Angiography ; Angiography, Digital Subtraction ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity

The electrocardiograms of a total of 12,796 patients taken in the past three years at Severance Hospital were reviewed for conduction disturbances which were found in 314 cases(2.46%). Th first degree atrioventricular block occurred in 65 cases, and second degree atrioventricular block with Wenckebach periodicity in 13. There were 9 cases of third degree atrioventricular block with nomal QRS complexes causing Adams-Stokes attacks which represented 2.9% of all conduction disturbances. It occurred equally in both sexes and predominantly after 6th decade of life. There were 99 cases of complete right bundle branch block(RBBB) and 12 cases of complete left bundle branch block(LBBB). The latter were mainly associated with significant heart diseases. As for the intraventricular conduction defects other than the simple bundle branch blocks, the findings were as follows; 1. Simple hemiblocks were found in 92 cases or 0.73% of total series and 29.3% of all conduction disturbances. Left anterior hemiblock(LAH) occurred 3 times more frequently than left posterior hemiblock(LPH). 2. Partial bilateral bundle branch block(BBBB) were found in 25 cases representing 0.2% of the total series and 8.0% of all conduction disturbances. Among the 25 cases of BBB, 11 had RBBB plus LAH, 10 RBBB plus LPH, 1 LBBB plus first degree A-V block, and 3 LBBB of diphtheritic cardic involvement. Trifascicular heart block causing Adams-Stokes attacks occurred in 9 of the 25 cases resulting in death in 7 cases. The underlying diseases were ischemic heart disease, hypertensive heart disease, congenital heart disease and diphtheritic carditis. This report represents the first electrocardiographical documentation of occurrence of trifascicular heart block progressing from BBBB in Korea.
Atrioventricular Block ; Bundle-Branch Block ; Electrocardiography* ; Heart Block ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Korea ; Myocardial Ischemia ; Myocarditis ; Periodicity

Percutaneous transluminal angioplasty(PTA) was first described by Dotter and Jukins in 1964 and subsequently modified by Gruentzig and Hoff in 1974. PTA has proved a safe and effective treatment for focal atherosclerotic disease of the aorta and its major extremity branches. The complications of PTA of the peripheral vessels are less frequent and less serve than those associated with the comparable surgical procedure. Intestinal angina is a clinical syndrome compromising postprandial abdominal pain, nausea, vomiting, diarrhea, weight loss, and eventually fear of eating. The syndrome is thought to be due to visceral ischemia, with stenosis or occlusion of the three visceral arteries being necessary for the syndrome to occur. Although the first report of mesenteric PTA appeared in 1980, the series of PTA with stenting of the visceral arteris reported in the literature have been small or included limited follow-up. We report a case of a intestinal angina due to superior mesenteric arterial stenosis. A 69-year-old male complained of serve postprandial pain, chronic diarrhea for 1 year. PTA with stening in superior mesenteric artery results in recannulation of obstructed artery and relief of symptom.
Abdominal Pain ; Aged ; Angioplasty* ; Aorta ; Arteries ; Chronic Pain ; Constriction, Pathologic ; Diarrhea ; Eating ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Male ; Mesenteric Artery, Superior ; Nausea ; Stents* ; Vomiting ; Weight Loss

Bacterial endocarditis is a disease with protean manifestations whose presentation has recently changed greatly. Right-sided endocarditis associated with congenital heart lesions is now relatively less common. Patients with ventricular septal defect are at risk for right-sided endocarditis, but its incidence is low in children and adolescents. The organism is frequently a staphylococcus and the clinical course is dominated by septic pulmonary infarction and septicemia. We reported two cases of pulmonic vegetation and pulmonary infarction associated VSD with brief review of literature.
Adolescent ; Child ; Endocarditis ; Endocarditis, Bacterial ; Heart ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Infarction* ; Sepsis ; Staphylococcus

Fewer than one half of patients with acute myocardial infarction is a candidate for thrombolytic therapy. Current data revealed that primary coronary stenting may be useful alternative to intravenous thrombolytic therapy for acute myocardial infarction in these subset of patients. We experienced a patient presenting with acute myocardial infarction and acute promyelocytic leukemia in whom thrombolytic therapy was thought be not eligible due to hemorrhagic tendency. Primary coronary stenting was performed successfully without complications. Follow-up angiography revealed no evidence of restenosis or stent occlusion.
Angiography ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; Myocardial Infarction ; Stents* ; Thrombolytic Therapy

The congenital pulmonary artery branch stenosis (PABS) was described by Oppenheimer (1) as early as in 1938, but it had attracted very little attention until the last decade. This disease is characterized grossly by single or multiple stenosis of the pulmonary artery and branches and has been described in the literature occasionally under the various designations including supravalvular pulmonary stenosis, coarctation of pulmonary artery, multiple peripheral stenosis of the pulmonary artery and pulmonary artery branch stenosis (3~22). It is known that this defect is no longer a very rare disease and functional problem only. The clinical significance of this disease is to differentiate from other congenital heart diseases such as patent ductus arteriosus, ventricular septal defect and pulmonic stenosis and is a cause of pulmonary hypertension. Nine cases of PABS confirmed by pressure difference in pullback tracing, selective angiography and rate of rise of pulmonary artery pressure are presented. This defect occurred as an isolated cardiovascular anomaly in 3 of the 9 patients. This condition was detected usually in childhood due to exertional dyspnea, frequent upper respiratory infections and heart murmur. Clinically the most significant diagnostic feature was the wide distribution of ejection systolic or continuous murmur, which was seldom louder than grade 4/6. It is also characteristic that the upstroke of the pulmonary artery pressure tracing is similar to the right ventricular tracing with the descending limb of the curve steeper and the dicrotic notch deeper with a low diastolic plateau. This results in a wide pulse pressure. Data are presented which suggest that comparing the rate of rise prestenotic with poststenotic pressure pulse may differentiate organic from functional pressure gradient. The purpose of this paper is to present in detail the clinical features including electrocardioram, chest X-ray, cardiac catherization, angiography, rate of rise of pulmonary artery pressure and diagnostic criteria of PABS. Only two cases of PABS were repoted in Korean literature from our laboratory.
Child ; Male ; Female ; Humans